Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Saturday, June 07, 2008

HIPAA, a law designed to protect patient privacy in the realm of medical information, is a huge stinking turd.

At my facility we just spent many hundreds of thousands of dollars to implement an electronic patient tracking system in the ER.

Besides taking pen and paper away from us and generating 8 pages of 'nursing notes' on every patient (to maximize billing), it took away our chalkboard which we used for years, with good effect, to show everyone where patients are, which doctor is seeing them, and which nurse is responsible for them.

Now we have a giant flat-screen plasma monitor (it's really quite beautiful with a crisp picture) which displays patient's room numbers, patient's initials, and coded symbols for doctors and nurses assigned to the patients. We are going out today to buy a chalk-board. Thanks to Dr. Deborah Peel, you freaking genius of bureaucratic masturbatory ignorance. Gotta go, "TH" is coding... Where are they? Who's their nurse? Shit.

15 comments:

Don't people realize their is no such thing as 'privacy' in the ER? Yelling in Nana's ear about her bowel movements and hearing a c.diff patient on the other side of a curtain is as private as you get. We call everyone by their CC anyway: the Renal Colic in 4, the SOB in 5, the Sore Throat in 2, The Abdo Nyd in 6. Can't get much more HIPaa than that. I actually had a 6 year old correct me one day when he overheard himself described in such a way, "I'm not just a sore throat". Touche you little bugger.

2. My PoopStrong mug came in today. It makes me happy. I'm going to start a photo journalism thingy on my blog dedicated to it. "This is the poopstrong mug next to the jaws of life." "This is the poopstrong mug in the ambulance." "This is the poopstrong mug next to the meth lab." I mean, it is a travel mug after all.

Most hospitals still have "semi-private" rooms. How much "patient privacy" is preserved between 'room mates'?

When the nurse asks your room mate about his bowel habits? Or his recent travel habits to countries with flourishing contagious diseases as part of the admit screening process? Or when the surgeon comes in to talk to your neighbor about his need for colo-rectal surgery?

This makes me feel a little better. I am sorry you are being screwed by Jcaho. But at least I know we are all subject to the incredible stupidity.

What really kills me is that Jcaho was invented to make things better. Why can't they just mandate we need more nurses to take care of the patient instead of giving that nurse who already has 8 patients (many of whom are almost dead) more stupid paperwork to do on each patient. I wish Jcaho would come in an do time studies on the workers. Oh, wait that might actually help.

"The Joint commission" (Their latest title change. they must think they are related to prince) May have been originally invented to make things better, but it has turned into a monstrosity of government involvement, along with big business. They don't want things to improve. If that happensa they may not be needed, and they couldn't charge repeat fees for coming back if you don't pass the first rectal exam.

Well, I'll say this much from experience...there is actually very little privacy when you are a patient, and it has almost nothing to do with the contents of your medical records. As spook, RN said above, how private is it when you've got people coming in and out all the time talking about your case? HIPAA doesn't do sh*t for that kind of loss of privacy!

I understand the original intentions of the law were decent, but in the real world, it's just another gigantic, bureaucratic, PITA. But then, isn't health care FULL of bureaucracy? Sure it is, I see it every day in HIM! And it appears to be getting more and more steeped in regulation. Is this of any benefit to patients? No, IMHO. The underlying problem is that everything in this country runs on the all mighty dollar, and health care is by nature expensive. The system needs a complete overhaul (don't know to what, but it does need it), but who's ready to take that project on?

I wonder if reducing patients to their conditions is some sort of defense mechanism, or is it just shorthand? Perhaps both? I don't think it's meant to be offensive. I saw it up close when I was laying there staring at one of those dry erase boards down in the surgery holding area...I, however, had enough medical background to make some sense out of it. It was kind of interesting.

Now we have to refer to folks as their condition. So we don't expose their infomation. I have been told, however, to not refer to patients as "Psycho chick in room 3." I think we should assign you a new name when you get to the hospital. Because so many women hyphenate, I don't know wtf your name is anyway. At least one name, I can get your records easier.

We just started using Wellsoft. I miss our big white board, but I love how I can do all the discharge/admit crap on one screen and have the printer spit out Rx's for me. It would be better if the plasma screen was a touch screen, I think.

""The Joint commission" (Their latest title change. they must think they are related to prince) "

HAHA

One of the hospitals we transport to just got one of those flat screens hanging on the wall, apprently they didn't get the "hanger" that locks it to the wall though, a crazy hyped patient ripped it from the wall last night.